Forms

If you cannot afford a court filing fee, use this form. The clerk may be able to waive the fee for you so you don’t have to pay.

Stop Debt Collection Calls and Exempt Income letter

This form is filed with the court to confirm that you sent court documents to the other party in a case. Be sure to find out what kind of service is required for your kind of court case.

Consumer Complaint

Use this form to file a consumer complaint in Vermont, for example if a debt collector does something they're not supposed to.

Use this form letter to tell debt collectors to stop calling you.

Disaster Forms

IRS Form 1040X: Amended US Individual Income Tax Return

Use this form to amend last year's return. For example, use this form if you are claiming a loss for the previous year due to a natural disaster.

IRS Form 4506-T: Request for Transcript of Tax Return

To request an IRS account transcript (computer printout), use this form. You can also use the short form, 4506T-EZ.

IRS Form 4506: Request for Copy of Tax Return

To request copies of tax returns, complete this form. Copies of past tax returns are free for people affected by a federally declared disaster area.

IRS Form 4506T-EZ: Request for Individual Tax Return Transcript

This is the short form version of Form 4506-T. Use this form to ask for a free tax transcript. It can be used in the foreclosure mediation process.

IRS Form 4684: Casualties and Thefts

To calculate and report casualty losses, such as after a natural disaster, you will need to complete this form.

IRS Form 8822: Change of Address

If you have a new address, complete this form to notify the IRS. Updating your address with the post office does not update it with the IRS.

Family Forms

Apply for Public Benefits

If you cannot afford a court filing fee, use this form. The clerk may be able to waive the fee for you so you don’t have to pay.

Use this link to apply for these Vermont programs: 3SquaresVT, Fuel Assistance, Reach Up and Essential Person.

Complaint About Discrimination in School

This form is filed with the court to confirm that you sent court documents to the other party in a case. Be sure to find out what kind of service is required for your kind of court case.

Use this form to file a complaint with the Vermont Human Rights Commission if you or your child has experienced discrimination at your child's school.

Form 813A - Financial Affidavit

Use this income and expense affidavit in family court in the state of Vermont.

Form 813B - Financial Affidavit

Use this property and asset affidavit in family court in the state of Vermont.

Inventory for an Estate in Probate

Fill out an inventory for an estate in probate court.

Notice Against Trespass

If you ask someone to stop coming into your home but the person keeps coming anyway, you can use a Notice Against Trespass to keep the person out.

Notice of Appearance

Use this form to give the court your contact information. Send them a new form if something changes. The court can then send you copies of any notices, court dates and paperwork filed in court.

Open an Estate in Probate

Fill out the paperwork you need to open an estate in probate court, when someone has died.

Parentage Complaint or Answer

Use the Summons and Complaint form if you want to start a parentage action. If you receive a Summons and Complaint, you need to send in the Answer within 21 days.

Prepare a Motion to Enforce Child Support

Prepare a motion to enforce your child support order in the state of Vermont.

Prepare a Motion to Modify Child Custody Order

Ask the court to change your child custody or visitation order.

Prepare a Motion to Modify Child Support

Ask the court to modify (change) your child support order in the state of Vermont.

Relief from Abuse Complaint & Affidavit

Learn how to get a Relief from Abuse (RFA) order and get the forms to use in our RFA Roadmap.

Respond to a Divorce, Civil Union Dissolution or Legal Separation

Respond to a divorce, civil union dissolution or legal separation Complaint from your partner by using an Answer form.

Start a Divorce, Civil Union Dissolution or Legal Separation

Get the forms you need to start a divorce, civil union dissolution or legal separation in Vermont.

Foreclosure Forms

If you cannot afford a court filing fee, use this form. The clerk may be able to waive the fee for you so you don’t have to pay.

IRS Form 4506T-EZ: Request for Individual Tax Return Transcript

This form is filed with the court to confirm that you sent court documents to the other party in a case. Be sure to find out what kind of service is required for your kind of court case.

Foreclosure Answer Form

Complete this form if you receive a foreclosure Complaint. You must file a written Answer within 21 calendar days of when you received the Complaint.

This is the short form version of Form 4506-T. Use this form to ask for a free tax transcript. It can be used in the foreclosure mediation process.

Request for Information Letter for Mortgage Assistance

Before you can get mortgage assistance payments through the Vermont COVID Emergency Mortgage Assistance Program, VHFA will need to talk to your mortgage servicer about your mortgage debt. Use this sample letter.

Medicaid Forms

Medicaid 205ALLMED Application

To apply for Medicaid for the Aged, Blind and Disabled (MABD) & Medicaid for the Working Disabled.

Vermont Medicaid Coverage Exception Request

If Vermont Medicaid tells you that it does not cover a service you need, you can ask for Medicaid to make an exception and cover the service.

Medicare Authorization to Disclose Personal Health Information Form

If you only need to apply for prescription help in Vermont, use the 201P application.

Medicare Forms

Use this form to allow Medicare to give your personal health information to someone other than you.

Medicare Savings Programs Application

To apply for Medicare Savings Programs.

Form to Revoke Power of Attorney

If you only need to apply for prescription help in Vermont, use the 201P application.

Power of Attorney Forms

Use this form to revoke (remove) Power of Attorney from your agent.

Power of Attorney for Financial Affairs Form

A Power of Attorney is a legal document to give another person authority to handle your financial and personal decisions.

Prescription Drug Forms

If you only need to apply for prescription help in Vermont, use the 201P application.

Probate Court Forms

Inventory for an Estate in Probate

This form is filed with the court to confirm that you sent court documents to the other party in a case. Be sure to find out what kind of service is required for your kind of court case.

Fill out an inventory for an estate in probate court.

Name Change Petition - Adult

Change your name in Vermont.

Open an Estate in Probate

Fill out the paperwork you need to open an estate in probate court, when someone has died.

Public Benefits Forms

Application for Energy Assistance from Green Mountain Power

Apply to the Green Mountain Power Energy Assistance Program for help providing electricity to your home.

Application for Energy Assistance from Vermont Gas Systems

Apply to the Vermont Gas Energy Assistance Program for help providing gas to your home.

Apply for Public Benefits

If you cannot afford a court filing fee, use this form. The clerk may be able to waive the fee for you so you don’t have to pay.

Use this link to apply for these Vermont programs: 3SquaresVT, Fuel Assistance, Reach Up and Essential Person.

Developmental Disability Services Request for a Fair Hearing

You can use a form to ask for a fair hearing if your request was denied or approved at less than you asked for, or if your amount goes down or stops.

Form to Appeal Public Benefits Decision

You have the right to appeal decisions from the Department for Children and Families (DCF) about your benefits. Use this form to appeal.

Housing Appeal Letter

Use this form letter to ask for a hearing if someone refuses to give you rent assistance or if your rent assistance or Section 8 is being stopped.

Preliminary Application for Housing/Rental Assistance in Burlington

Use this form to apply for housing/rental assistance in Burlington.

Reach Up Grant Decrease Appeal Form Letter

If your Reach Up grant recently went down (decreased), you can appeal with this Form Letter.

Vermont Fuel Assistance Application

To find out if you’re eligible for Fuel Assistance to help pay for your home heating bills, fill out this application.

You First Health Program Application

If you only need to apply for prescription help in Vermont, use the 201P application.

You First is a health program for Vermont women with a low income.

Relief from Abuse

Relief from Abuse Complaint & Affidavit

Learn how to get a Relief from Abuse (RFA) order and get the forms to use in our RFA Roadmap.

Renter (Tenant) / Landlord

Application for Energy Assistance from Green Mountain Power

Apply to the Green Mountain Power Energy Assistance Program for help providing electricity to your home.

Application for Energy Assistance from Vermont Gas Systems

Apply to the Vermont Gas Energy Assistance Program for help providing gas to your home.

Apply for Public Benefits

If you cannot afford a court filing fee, use this form. The clerk may be able to waive the fee for you so you don’t have to pay.

Use this link to apply for these Vermont programs: 3SquaresVT, Fuel Assistance, Reach Up and Essential Person.

Disability - Request for Reasonable Accommodations or Modifications in Your Housing

This form is filed with the court to confirm that you sent court documents to the other party in a case. Be sure to find out what kind of service is required for your kind of court case.

When a person’s disabilities prevent them from using or enjoying their housing in the same way as people without disabilities, they can ask for reasonable changes in their housing.

Eviction Answer Form

Use this Answer form when the landlord is trying to evict you. Generally, a tenant/defendant must file an Answer within 21 days after the day the Complaint was served.

Eviction Counterclaims Form

Use this counterclaims form during the eviction process, if needed.

Housing Appeal Letter

Use this form letter to ask for a hearing if someone refuses to give you rent assistance or if your rent assistance or Section 8 is being stopped.

Housing Discrimination Complaint Form for Vermont Human Rights Commission

To file a housing discrimination complaint with the Vermont Human Rights Commission, fill in this form.

Letter to Landlord about Access

Use this letter to let your landlord know about the law about coming into your apartment.

Letter to Report Change in Income to Subsidized Housing

In most kinds of subsidized housing, you can ask for your rent to be recalculated if your income drops. We have created a form letter that you can use.

Motion to Redeem [Eviction]

If an eviction is solely for non-payment of rent, you may be able to stop the eviction by paying all rent and court costs. Then use this form.

Notice Against Trespass

If you ask someone to stop coming into your home but the person keeps coming anyway, you can use a Notice Against Trespass to keep the person out.

Preliminary Application for Housing/Rental Assistance in Burlington

Use this form to apply for housing/rental assistance in Burlington.

Repair and Withholding Letter to Landlord

Use this letter to tell your landlord you have defects in your rental unit that materially affect health and safety.

Repair Letter to Landlord

Use this form letter to tell your landlord about repairs needed at your home.

Security Deposit Return Letter

Use this form letter to ask your landlord to return your security deposit.

Vermont Fuel Assistance Application

To find out if you’re eligible for Fuel Assistance to help pay for your home heating bills, fill out this application.

VT Renter Credit / Renter Rebate Claim

Use form RCC-146 from the Vermont Department of Taxes to claim the renter credit, formerly called the renter rebate.

Small Claims Forms

Ask the Court to Order Financial Disclosure

If you cannot afford a court filing fee, use this form. The clerk may be able to waive the fee for you so you don’t have to pay.

In a small claims case, use this form to ask the court to order the other party to give you and the court more information about their financial situation.